N522Remark Code (RARC)Active
N522 Remark Code - Duplicate Claim Processed
The N522 remark code indicates that the claim in question is a duplicate of another claim that has already been processed, or it is intended to be processed as a crossover claim. This remark serves to clarify the adjustment noted by the accompanying reason code, providing additional context for the denial or adjustment.
How It Relates to the Denial
Typically, the N522 remark accompanies reason codes that relate to duplicate claims or crossover claims. This combination signals that the payer has already processed a similar claim, affecting the payment of the current submission.
Common Scenarios
1A provider submits a claim for a service that the patient received, but the remittance advises that the claim is a duplicate. The claim was already processed as a crossover to Medicare, which the provider did not realize.
→ The N522 remark indicates that the payer has identified this claim as a duplicate due to it being processed as a crossover claim, meaning it should not be paid again.
2A billing office receives a remittance for a claim submitted for a patient who is covered by both a primary and a secondary payer. The remittance notes a duplicate claim for the secondary payer.
→ In this situation, the N522 remark suggests that the secondary payer recognizes the claim as already having been processed by the primary payer, thus it will not issue a separate payment.
3A practice bills for a procedure after a patient has switched insurance plans, but the remittance indicates that the claim is a duplicate of a previous submission to another payer.
→ The N522 remark here highlights that the claim is deemed a duplicate because it has already been processed by another payer, which could be due to the crossover arrangement.
What to Do
- Verify if the claim was indeed submitted previously and ensure there is no duplicate billing.
- Check if the claim should have been submitted as a crossover claim based on the patient's insurance coverage.
- If applicable, consider resubmitting the claim with the correct crossover information.
What to Check
- Review the patient's claim history to confirm if a similar claim was submitted previously.
- Examine the payer's crossover claim policies to determine if this claim should have been processed differently.
- Look at the adjustment reason code on the remittance for additional context regarding the duplicate claim.